Practical surgical tips on performing upper blepharoplasty.

Upper lid blepharoplasty is a surgical procedure that requires meticulous planning and execution. It is not a standalone procedure but can be combined with ptosis correction surgery. Prior to surgery, thorough lid examinations are essential to determine the appropriate approaches. Skin markings for incision sites should be drawn before anesthesia injection to avoid distortion of lid wrinkles and creases. The design of the lid crease is crucial, with a nasal tapered crease serving as a guide for subsequent parallel crease drawings. Incisions should be made with care to avoid excessive bleeding, particularly from the orbicularis muscles. It is important to control bleeding promptly to prevent secondary ptosis during the early post-operative period. When releasing the orbital septum, care should be taken to avoid injury to surrounding structures, particularly the trochlea nasally and the lacrimal gland laterally. Moist cotton tip applicators can be used to safely separate fat from the underlying aponeurosis.